1Vilnius University, Faculty of Medicine, Vilnius, Lithuania
Introduction. Type 1 diabetes (T1D) is characterised by insulin deficiency, caused by autoimmune destruction of the pancreatic beta cells. The main treatment of T1D is the administration of exogenous insulin. An ideal treatment for T1D is thought to be an intervention, that can mimic pancreatic endocrine function and ensure glucose homeostasis in the body. Therefore, new technologies are being developed and improved in this direction, which can help to achieve better control of T1D and reduce the burden of treatment T1D for patients. The Aim: to review the stages of Artificial Pancreas (AP) development and the most important directions of improvement and the role of this technology in the treatment of T1D. To review challenges related to the application of AP in clinical practice. Methods. This literature review discusses the stages of AP development based on a 6-stage project, presented in 2006 by the Juvenile Diabetes Research Foundation (JDRF). The search terms used to identify publications on PubMed, UpToDate included “artificial pancreas”, “closed-loop insulin”, “bi-hormonal”, “glucagon”. Publications, evaluating the efficacy and benefits of AP systems for the control of T1D treatment, are included. Findings. Primarily, a very important step in the treatment of T1D was the development of glucose monitoring and insulin delivery devices to a glucose sensor, that continuously monitors glucose in the interstitial fluid and insulin pumps to provide continuous subcutaneous insulin infusion and the application of these technologies in clinical practice. Subsequent systems introduced basal insulin infusion automation systems, which were a great start to the development of the AP, otherwise known as the closed-loop system. Conclusions: AP is currently one of the fastest growing and researched technologies, facing many challenges in its application in clinical practice, but based on recent research, offers high hopes for better treatment of T1D and facilitates self-control of patients with T1D.
Keywords: diabetes, pancreas, insulin.